​​​​​​The 'Hidden' Cost of Cancer

23 October 2017

With 1 in 4 South Africans affected by cancer, it is clear that the prevalence of cancer is increasing. This includes cervical cancer, which the World Health Organisation reports as the second most common cancer in women worldwide. However, despite its high incidence rate of 500 000 new cases annually, it's not frequently spoken about – and certainly not from a financial perspective of all the costs involved.

This is true of all cancers: often the true financial cost of the illness remains largely undocumented. As a result, many patients and their families are caught unprepared for the 'hidden' expenses associated with cancer – like a wig or a scarf, comfortable clothes that fit, the petrol to get to appointments and a nourishing diet to nurture recovery.

The cost of cancer is not just high in South Africa, but in America a third of the population is plunged in debt due to the cost of cancer. This is according to the Kaiser Centre for Health Research on a group of American cancer patients aged 18 to 64.

Deon Theunis, head of distribution support at Sanlam Individual Life, says, “While it's advisable for people to be prepared with medical aid, severe illness cover and other policies, it's also vital for them to understand the extent of the additional expenses that aren't directly related to treatment. The full financial picture of the cost of cancer really only emerges when one understands these expenses and know what a policy does and does not cover.”

With that in mind, here are some estimations of the potential 'hidden costs' of cancer:

• Wigs: Hair loss is one of the side-effects of chemotherapy. PriceCheck suggests human hair wigs cost anything from R400 to R4000 (the average being R1000 – R2000), but some salons give discounts to cancer patients and CANSA distributes wigs made from donated hair free of charge when available. The organisation also has a bank of acrylic wigs for patients to borrow from.
• New clothes: Weight loss is something many cancer patients experience. It's a good idea to get few key wardrobe pieces during treatment and recovery that fit and are made from gentle, loose-fitting fabrics. Set aside approximately R3000 for clothes, including a variety of hats, slippers, a dressing gown and pyjamas.
• Dietary requirements: There's a myriad of advice online regarding the best diet for different kinds of cancers so it's advisable to speak to a dietitian or doctor about this. Often there'll be days when a patient won't feel hungry so it's good to have healthy snacks and pre-prepared small meals on hand. According to a recent food barometer, you should budget around R2500 per month for healthy food.
• Transport, to and from appointments: Weekly appointments to various doctors and treatment centres can mean a lot of driving around or use of public transport. Petrol prices are currently (at the time of writing) fluctuating around R14.00 per litre for 95 unleaded, so it's advisable to measure distances on Google Maps and multiply these by the current petrol rate and frequency of trips to get an estimated overall cost per month. Some small towns in the Eastern Cape and KwaZulu Natal for instance, do not have cancer specialists. They often need to travel longer distances or budget for alternative accommodation to be closer to their treatment centres.
• Household expenses: Other unexpected increases relate to general household expenses like water, electricity, the internet and telephone. With patients often at home more, all these costs escalate costing up to R1000 extra per month.
• Complementary therapies: Some patients seek alternative holistic therapies like acupuncture as part of the recovery process and others may opt to see a psychologist for mental and emotional support. According to the South Africa Depression and Anxiety Group, appointments with a psychologist can cost between R600 – R 1200 per session.
• Home modifications: If an illness has an effect on a patient's mobility or strength, it might be necessary to modify or renovate parts of the home to make it more navigable, for example, making sure the person's bedroom and bathroom are on the ground floor. The scope of these modifications will vary – it may be as simple as making the bathroom floors non-slip and adding grab-bars for the shower, bath and toilet.
• Home care: A live-in carer can cost anything from R3500 to R7500 (the average salary according to Payscale is R4000) per month or more. St Luke's Hospice provides free palliative care to patients and their families – the organisation is funded by donations – including home care, in-ward care and counselling.
• Out of pocket medical costs: Last year, the South African Medical Journal published an article which cited concerns over the escalating costs of cancer treatment in SA. It said medical costs have reached a point where medical aid limits are starting to fall short of covering even older-generation therapies, let alone new interventions such as biological drugs. A gap cover product can help fund the difference between what a patient's medical scheme covers and what the total cost of treatment amounts to. However, given that it typically pays up to 500% of medical scheme rates and that gap cover payments are now capped at R150 000 per beneficiary per year, severe illness cover can go a long way to cover out-of-pocket medical costs too.

While all these expenses can seem overwhelming, being aware of and planning for them can help alleviate financial strain – especially if a patient already has severe illness cover in place.